I'm not at all a provider contracting expert but do know when it feels like I'm paying too much for occupational therapy exercises for my son's wrist injury.

These services weren't performed at University Hospitals Ahuja Campus, but at a remote UH location. My bill (after BCBS 'discount') was $252, which is $84 per unit for the 3 different exercises (I'm guessing) done in the 30 minute visit. I imagine this was so high because Anthem, Inc. doesn't have a professional contracted rate for this service with Ahuja, like ALL the other commercial payers do. Why wouldn't Anthem have a professional rate?

I sure would have liked Medical Mutual's $17.39 rate for this BUT also feel that is way too low for 30 minutes of time from an occupational therapist. Even Medicare would pay $26.03 for this.

With the availability of price transparency data, one would expect this range of commercial reimbursement rates to shrink, but only time will tell if payers and providers take advantage of this data being available.